Gastroenterology & Hepatology — Flashcards

Flashcard 551: What is the initial management of bowel obstruction (small & large)? 1. _____ 2. NG tube for decompression 3. IV fluids

Answer: Nil by mouth

Extra: Initial management for both small and large bowel obstruction (drip and suck): 1. NPO (Nil per os) to rest the bowel. 2. Nasogastric (NG) tube decompression to relieve proximal pressure. 3. Aggressive IV fluid resuscitation and electrolyte correction. Note: While the general initial steps are similar, the definitive management (and urgency of surgery) often differs significantly between SBO (often adhesional, trial of conservative) and LBO (often neoplastic, more likely surgical).

Flashcard 552: The only curative mainstay of management for pancreatic cancer is _____.

Answer: Surgical resection (e.g. Whipple procedure)

Extra: Pancreatic cancer often presents late. While surgery is the curative mainstay, ~80% of patients are unresectable at diagnosis and receive palliative care (analgesia, biliary stenting, etc.).

Flashcard 553: Hiatus hernia can present as symptoms associated with _____

Answer: GORD

Flashcard 554: _____ diagnosis should be considered if the patient has the following for ≥ 6 months: Abdominal pain and/or Bloating and/or Change in bowel habit

Answer: Irritable Bowel Syndrome

Flashcard 555: _____ is the sudden inflammation of the pancreas characterised by abdominal pain & elevated pancreatic enzymes.

Answer: Acute pancreatitis

Extra: Diagnosis of Acute Pancreatitis requires 2 of 3: 1. Acute epigastric pain radiating to the back. 2. Serum amylase or lipase >3x Upper Limit of Normal (ULN). 3. Characteristic findings on imaging (CT/MRI/Ultrasound).

Flashcard 556: Pancreatic cancer causes _____ jaundice which results in pale stools & dark urine

Answer: obstructive

Flashcard 557: Small bowel is considered dilated if > _____cm diameter

Answer: 3

Flashcard 558: _____ is the blockage of the large intestine that impedes passage of intestinal contents

Answer: Large bowel obstruction

Flashcard 559: _____ suggests that a palpable, nontender/painless gallbladder is caused by pancreatic / gallbladder cancer, not a stone.

Answer: Courvoisier's law

Flashcard 560: Lifestyle advice for IBS... _____

Answer: - Eat regular meals and take time to eat - Avoid missing meals - Drink at least 8 cups of fluid per day - Restrict tea & coffee to 3 cups a day - Reduce intake of alcohol & fizzy drinks - Limit intake of high-fibre food - Limit fresh fruit to 3 portions a day - Encourage oats for wind & bloating - Encourage regular physical activity